scholarly journals Experience of using a systemic glucocorticosteroid as an initial therapy for post-COVID-19 arthritis in outpatient practice

2021 ◽  
Vol 5 (5) ◽  
pp. 252-256
Author(s):  
V.E. Yershov ◽  
◽  
A.V. Krivova ◽  
V.P. Zakharov ◽  
S.V. Bystrov ◽  
...  
Keyword(s):  
Reactive Arthritis ◽  
Initial Therapy ◽  
Transmitted Infection ◽  
Dose Administration ◽  
Number Of Patients ◽  
Inflammatory Drugs ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
Outpatient Practice ◽  
Russian Medical

ABSTRACT Amid the COVID-19 pandemic, a large number of patients with joint lesions resistant to nonsteroidal anti-inflammatory drugs (NSAIDs) was encountered in our clinical practice. The article summarizes the positive experience of outpatient therapy of 916 patients (mean age 47.1±11.3 years), including 774 women, with arthritis of various localization, which occurred on average 45.0±7.1 days after a previously transmitted infection caused by SARS-CoV-2. 709 (77.4%) patients used NSAIDs before going to the clinic, the effect of which was absent or insufficient. In this regard, intramuscular injections of betamethasone prescribed to 823 patients were used as the initial therapy (considering the comorbid background and allergy history). During the drug intake, most of the patients had relief of inflammation, pain reduction, improvement of the disease segment function already on the 7th day. In 69.3% of cases, a single-dose administration was sufficient. The obtained results allow drawing preliminary conclusions about the feasibility of using this technique in the complex treatment of reactive arthritis after the SARS-CoV-2 infection. KEYWORDS: coronavirus infection, COVID-19, glucocorticosteroids, nonsteroidal anti-inflammatory drugs, reactive arthritis. FOR CITATION: Yershov V.E., Krivova A.V., Zakharov V.P., Bystrov S.V. Experience of using a systemic glucocorticosteroid as an initial therapy for post-COVID-19 arthritis in outpatient practice. Russian Medical Inquiry. 2021;5(5):252–256 (in Russ.). DOI: 10.32364/2587- 6821-2021-5-5-252-256.

Ibuprofen safety at the golden anniversary. A commentary and recent developments

2020 ◽  
Keyword(s):  
The World ◽  
Recent Developments ◽  
Inflammatory Drugs ◽  
Coronavirus Infection ◽  
Interesting Story ◽  
Anti Inflammatory ◽  
Short Comment ◽  
Published Paper

Ibuprofen is a long lasting non-steroidal anti-inflammatory drugs (NSAIDs) and still represents one of the most diffused analgesics around the world. It has an interesting story started over 50 years ago. In this short comment to an already published paper, the authors try to focus some specific important point. On top, they illustrate the recent, confusing and fake assertion on the potentially dangerous influence that ibuprofen could have, increasing the risk of Coronavirus infection. This is also better illustrated in a previously published paper, where the readers could find more clear responses to eventual doubts.

scholarly journals Beyond the guidelines management of juvenile idiopathic arthritis: a case report of a girl with polyarticular disease refractory to multiple treatment options and Leri Weill syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vana Vukić ◽  
Ana Smajo ◽  
Mandica Vidović ◽  
Rudolf Vukojević ◽  
Miroslav Harjaček ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Treatment Options ◽  
Janus Kinase ◽  
Musculoskeletal Symptoms ◽  
Multiple Treatment ◽  
Number Of Patients ◽  
Systemic Glucocorticoids ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Background The last two decades brought new treatment options and high quality guidelines into the paediatric rheumatologic practice. Nevertheless, a number of patients still present a diagnostic and therapeutic challenge due to combination of vague symptoms and unresponsiveness to available treatment modalities. Case presentation We report a case of sixteen years old girl suffering from polyarticular type of juvenile idiopathic arthritis refractory to multiple treatment options. She first presented at the age of 4 with swelling and contractures of both knees. Her symptoms were initially unresponsive to nonsteroidal anti-inflammatory drugs and progressed despite treatment with intraarticular and systemic glucocorticoids and methotrexate. Throughout the years, she received several biologics together with continuous administration of nonsteroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs as well as intraarticular and systemic glucocorticoids in disease flares. However, none of this options  provided a permanent remission, so various other modalities, as well as other possible diagnoses were constantly being considered. Eventually she became dependent on a daily dose of systemic glucocorticoids. In 2018, the treatment with Janus kinase inhibitor tofacitinib was initiated, which led to gradual amelioration of musculoskeletal symptoms, improvement of inflammatory markers and overall well-being, as well as to the weaning of systemic glucocorticoids. As the swelling of the wrists subsided for the first time in many years, Madelung’s deformity was noticed, first clinically, and later radiographically as well. Genetic analysis revealed short-stature homeobox gene deficiency and confirmed the diagnosis of Leri Weill syndrome. Conclusions This case report emphasizes the need for reporting refractory, complicated cases from everyday clinical practice in order to build-up the overall knowledge and share experience which is complementary to available guidelines. Individual reports of difficult to treat cases, especially when additional diagnoses are involved, can be helpful for physicians treating patients with common rheumatological diseases such as juvenile idiopathic arthritis.

scholarly journals Efficacy and safety of non-steroidal anti-inflammatory drugs for acute attack of gout

2021 ◽  
Vol 5 (2) ◽  
pp. 96-101
Author(s):  
V.B. Vasilyuk ◽  
◽  
G.I. Syraeva ◽  
M.V. Faraponova ◽  
◽  
...  
Keyword(s):  
Inflammatory Arthritis ◽  
Adverse Reactions ◽  
Acute Attack ◽  
Therapeutic Modality ◽  
Efficacy And Safety ◽  
Nsaid Treatment ◽  
Depth Analysis ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Russian Medical

Gout is one of the most common forms of inflammatory arthritis. Medical care for gout includes non-steroidal anti-inflammatory drugs (NSAIDs). This paper reviews the efficacy and safety of NSAIDs prescribed for the acute attack of gout, in particular, AMBENIUM® parenteral. It was demonstrated that phenylbutazone is a powerful NSAID that provides significant analgesic and anti-inflammatory effects. Considering a broad spectrum of adverse reactions of NSAIDs, these agents should be prescribed and used under in-depth analysis of patient’s condition, comorbidities and the level of their decompensation, and potential drug interactions. In addition, optimal dosages and duration of NSAID treatment are of particular importance. The authors conclude that AMBENIUM® parenteral is an effective and safe therapeutic modality for gout. Its profile and risk/benefit ratio are regarded as “favorable” compared to other NSAIDs. KEYWORDS: gout, arthritis, pain, non-steroidal anti-inflammatory drugs, parenteral, efficacy, safety. FOR CITATION: Vasilyuk V.B., Syraeva G.I., Faraponova M.V. Efficacy and safety of non-steroidal anti-inflammatory drugs for acute attack of gout. Russian Medical Inquiry. 2021;5(2):96–101. DOI: 10.32364/2587-6821-2021-5-2-96-101.

Long-term use of nonsteroidal anti-inflammatory drugs for pain control in patients with osteoarthritis: results of the 12-month observational study AELITA (Analgesia: Effective Treatment Using The Therapeutic Algorithm)

2021 ◽  
Vol 15 (6) ◽  
pp. 84-90
Author(s):  
A. E. Karateev ◽  
E. Yu. Polishchuk ◽  
E. S. Filatova ◽  
A. S. Potapova ◽  
V. A. Nesterenko ◽  
...  
Keyword(s):  
Pain Control ◽  
Rating Scale ◽  
Health Assessment ◽  
Pain Reduction ◽  
Time Frame ◽  
Number Of Patients ◽  
Primary Means ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Non-steroidal anti-inflammatory drugs (NSAIDs) are the primary means of managing chronic osteoarthritis (OA) pain. The choice of NSAIDs is based on an analysis of the risk of adverse reactions (ARs). Objective: to evaluate the efficacy and safety of long-term use of NSAIDs for pain control in patients with OA in real clinical practice.Patients and methods. To assess the results of long-term use of NSAIDs in OA, a 12-month observational non-interventional study was conducted. It included 611 patients with knee, hip and generalized OA, and nonspecific back pain associated with OA of the facet joints. All patients were prescribed aceclofenac (Aertal®) 200 mg/day. The patients' condition was assessed 2 weeks, 3, 6, 9 and 12 months after the start of therapy. The following parameters were determined: the intensity of pain during movement and the general health assessment (GA) according to the visual analogue scale (VAS, 10 cm); pain intensity according to the Likert verbal rating scale (VRS) (0–4); the number of patients with a pain reduction of ≥50% from baseline; patients' assessment of the result of therapy according to Likert VRS (1–5). The development of ARs was recorded at each visit.Results and discussion. By month 12, 46.8% of patients had dropped out of observation. In patients who continued the study, the average severity of pain according to the VAS at baseline, after 2 weeks, 3, 6, 9 and 12 months was: 6.5±1.2; 4.8±1.4; 3.2±1.4; 2.6±1.4; 2.2±1.1; 1.4±1.1 cm, respectively (significant differences compared to the baseline for all points – p<0.05). The same differences were obtained in GA assessment.Within the indicated time frame, the number of patients with moderate / severe pain (on the Likert scale) decreased from 77.8 to 24.9; 2.9; 2.3; 0.9 and 0%, respectively. The number of patients with a pain reduction of ≥50% from baseline was 12.0; 65.1; 81.0; 88.5 and 84.0%, respectively. A good or excellent assessment of treatment results after 2 weeks was given by 63.3% of patients, and after 12 months – by 95.6%. ARs were observed in about 30% of patients, mainly mild or moderate dyspepsia (in 11.1–23.3%) and arterial hypertension (in 7.1–10.9%). No serious ARs were registered.Conclusion. Aceclofenac is an effective and relatively safe drug for the long-term management of chronic pain in OA.

DO NSAIDS CAUSE SPECIFIC COMPLICATIONS IN COVID-19 CORONAVIRUS INFECTION?

2020 ◽  
Vol 58 (3) ◽  
pp. 340-343 ◽  
Author(s):  
A. E. Karateev ◽  
E. L. Nasonov ◽  
A. M. Lila
Keyword(s):  
Gastrointestinal Tract ◽  
Elderly Patients ◽  
Cardiovascular System ◽  
Clinical Evidence ◽  
Correct Diagnosis ◽  
Viral Diseases ◽  
Inflammatory Drugs ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
Comorbid Diseases

Currently, there is no clear data indicating the risk of specific complications when using non-steroidal anti-inflammatory drugs (NSAIDs), and in particular ibuprofen, for COVID-19 infection. There is also no clear clinical evidence that taking NSAIDs increases the risk of COVID-19 infection. However, when using NSAIDs in patients with acute respiratory viral diseases, keep in mind the possibility of class-specific complications from the gastrointestinal tract, cardiovascular system and kidneys. This risk is quite serious in elderly patients with multiple comorbid diseases. In addition, you should remember that taking NSAIDs and paracetamol can mask important symptoms of COVID-19 infection (in particular, fever) and lengthen the time for making a correct diagnosis.

scholarly journals Clinical Diagnostic and Therapeutic Characteristics of COVID-19 in Students of Kyrgyzstan

2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Zh. Esenalieva ◽  
Sh. Brimkulov ◽  
Sh. Sulaimanov ◽  
Zh. Muratova ◽  
E. Chernyshova
Keyword(s):  
Therapeutic Interventions ◽  
X Rays ◽  
Shortness Of Breath ◽  
Weak Correlation ◽  
Clinical Diagnostic ◽  
Inflammatory Drugs ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
Pcr Test ◽  
D Dimer

The study included 747 students. Out of 747 students 399 (53.4%) were women and 348 (46.6%) were men. According to the respondents, 22.6% (n=169) of them had a new coronavirus infection. Different symptoms of COVID-19 were observed in 72.58% of those interviewed. They were loss of taste (82.8%), fever (67.4%) and headache (67.4 %). Chills (47.3%), coughing (40.8%), pain in the throat (36.6%), shortness of breath (23.6%) and nausea (21.3%) were less frequent. 27.4% of respondents can assume asymptomatic course of the disease. A direct weak correlation between smoking and symptoms (cough, shortness of breath) of COVID-19 (r=0.39) has been identified. 59.8% (n=447) of respondents were diagnosed via PCR-test. At the same time, 62.2% (n=278) of the students had no COVID-19 confirmation. Antibodies to SARS-CoV-2 were determined in a total of 28.51% (n=213) of the respondents. Fibrinogen and D-dimer levels were determined in 9.4% and 7.1% of the students surveyed, respectively. Chest X-Rays were done in 22.6% (n=169) of respondents. Antibacterial and anti-inflammatory drugs (75.1%) were clearly prevalent among young students in the structure of therapeutic interventions for new coronavirus infection.

scholarly journals Patients With Atrial Fibrillation Taking Nonsteroidal Anti-Inflammatory Drugs and Oral Anticoagulants in the ARISTOTLE Trial

Circulation ◽  
2020 ◽  
Vol 141 (1) ◽  
pp. 10-20 ◽  
Author(s):  
Frederik Dalgaard ◽  
Hillary Mulder ◽  
Daniel M. Wojdyla ◽  
Renato D. Lopes ◽  
Claes Held ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Gastrointestinal Bleeding ◽  
Major Bleeding ◽  
Oral Anticoagulants ◽  
Clinical Trial Registration ◽  
Risk Of Bleeding ◽  
Number Of Patients ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Background: The use of nonsteroidal anti-inflammatory drugs (NSAIDs) with oral anticoagulants has been associated with an increased risk of bleeding. We investigated the risk of bleeding and major cardiovascular outcomes in patients with atrial fibrillation taking NSAIDs and apixaban or warfarin. Methods: The ARISTOTLE trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation; n=18 201) compared apixaban with warfarin in patients with atrial fibrillation at an increased risk of stroke. Patients in ARISTOTLE without severe renal (creatine clearance ≤30 mL/min) or liver disease were included in this analysis (n=17 423). NSAID use at baseline, NSAID use during the trial (incident NSAID use), and never users were described. The primary outcome was major bleeding. Secondary outcomes included clinically relevant nonmajor bleeding, gastrointestinal bleeding, heart failure hospitalization, stroke or systemic embolism, and all-cause mortality. NSAID use during the trial, and the interaction between randomized treatment, was analyzed using time-dependent Cox proportional hazards models. Results: Those with baseline NSAID use (n=832 [4.8%]), incident NSAID use (n=2185 [13.2%]), and never users were similar in median age (age [25th, 75th]; 70 [64, 77] versus 70 [63, 75] versus 70 [62, 76]). Those with NSAID use at baseline and incident NSAID use were more likely to have a history of bleeding than never users (24.5% versus 21.0% versus 15.6%, respectively). During a median follow-up (25th, 75th) of 1.8 (1.4, 2.3) years and when excluding those taking NSAID at baseline, we found that incident NSAID use was associated with an increased risk of major bleeding (hazard ratio [HR], 1.61 [95% CI, 1.11–2.33]) and clinically relevant nonmajor bleeding (HR, 1.70 [95% CI, 1.16–2.48]), but not gastrointestinal bleeding. No significant interaction was observed between NSAID use and randomized treatment for any outcome. Conclusions: A substantial number of patients in the ARISTOTLE trial took NSAIDs. Incident NSAID use was associated with major and clinically relevant nonmajor bleeding, but not with gastrointestinal bleeding. The safety and efficacy of apixaban versus warfarin appeared not significantly to be altered by NSAID use. This study warrants more investigation of the effect of NSAIDs on the outcomes of patients treated with apixaban. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00412984.

scholarly journals Localized and targeted delivery of NSAIDs for treatment of inflammation: A review

2018 ◽  
Vol 244 (6) ◽  
pp. 433-444 ◽  
Author(s):  
Rebecca M Haley ◽  
Horst A von Recum
Keyword(s):  
Drug Delivery ◽  
Side Effects ◽  
Targeted Delivery ◽  
Local Drug Delivery ◽  
Future Research ◽  
Systemic Delivery ◽  
Number Of Patients ◽  
Long Term Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Inflammatory processes are increasingly being identified at the core of many different disease states (e.g. heart disease, cancer, diabetes). As such, anti-inflammatory strategies available through drug delivery have undergone renewed interest. Due to the systemic side effects of steroidal drugs, non-steroidal anti-inflammatory drugs are often preferred for long-term treatment of inflammation in a variety of applications. While non-steroidal anti-inflammatory drugs are generally safe, there are some serious side effects that can be associated with their usage, particularly when given systemically or orally. Due to the high number of patients taking non-steroidal anti-inflammatory drugs, the reduction or elimination of these side effects, such as is possible through local drug delivery, could have a very powerful effect on patient quality of life. This review comments on a sampling of existing methods for localized or targeted delivery of non-steroidal anti-inflammatory drugs, with the goal of helping future research groups to focus on bettering methods shown to be effective and filling the gaps of knowledge in this field. Additionally, commentary is made on the field as a whole, and the standardization issues that arise from its expansiveness and diversity. Impact statement This work provides an overview of research currently being done exploring potential drug delivery device strategies for NSAIDs as an alternative to systemic delivery. Commentary on this field is made in an attempt to aid future experimental design, enabling researchers to determine the drugs and delivery vehicles which are most advantageous for them to pursue, as well as suggestions to standardize the reporting of such future research.

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